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血管免疫母细胞样T细胞非霍奇金淋巴瘤:33例患者化疗后的预后及文献复习

Angioimmunoblastic-like T-cell non Hodgkin's lymphoma: outcome after chemotherapy in 33 patients and review of the literature.

作者信息

Pautier P, Devidas A, Delmer A, Dombret H, Sutton L, Zini J M, Nedelec G, Molina T, Marolleau J P, Brice P

机构信息

Hôpital Saint-Louis, Paris, France.

出版信息

Leuk Lymphoma. 1999 Feb;32(5-6):545-52. doi: 10.3109/10428199909058412.

Abstract

We analyzed 33 patients with AILD T-NHL in a retrospective multicentric study. The median age was 62 yr (35-84 yr) (19 patients over 60 yr). Advanced disease (n = 31) and B-symptoms were consistently found (n = 29) and 20 patients had bone marrow involvement. The main laboratory abnormalities were: anemia (n = 13), hypereosinophilia (n = 13), lymphopenia (n = 14), hypergammaglobulinemia (n = 17), elevated lactate dehydrogenase (LDH) level (n = 24). First-line therapy was chemotherapy (ChT) alone (n = 25) or ChT after steroids (n = 8). Most patients received a CHOP-like regimen for a median number of 6 cycles and 3 patients received interferon alpha (IFN alpha) as consolidation after chemotherapy. With a median follow-up of 46 mo, 60% achieved a complete response but the outcome was poor with a relapse rate at 56%, a median survival referring to the total population was of 36 mo (2-108+ mo) and an overall survival at 5 yr of 36%. Two patients received high-dose chemotherapy (with total body irradiation) and autologous progenitor-cell transplantation for chemosensitive relapse and were free of disease at, respectively, 76 and 24 mo+. In conclusion AILD T-NHL still has a poor prognosis compared to other NHL. The role of intensive therapy and IFN alpha still remains to be evaluated.

摘要

我们在一项回顾性多中心研究中分析了33例AILD T-NHL患者。中位年龄为62岁(35 - 84岁)(19例年龄超过60岁)。一致发现存在晚期疾病(n = 31)和B症状(n = 29),20例患者有骨髓受累。主要实验室异常包括:贫血(n = 13)、嗜酸性粒细胞增多(n = 13)、淋巴细胞减少(n = 14)、高球蛋白血症(n = 17)、乳酸脱氢酶(LDH)水平升高(n = 24)。一线治疗为单纯化疗(ChT)(n = 25)或类固醇治疗后化疗(n = 8)。大多数患者接受CHOP样方案,中位疗程为6个周期,3例患者在化疗后接受干扰素α(IFNα)巩固治疗。中位随访46个月,60%达到完全缓解,但预后较差,复发率为56%,总体人群的中位生存期为36个月(2 - 108 +个月),5年总生存率为36%。2例患者因化疗敏感复发接受了高剂量化疗(全身照射)和自体祖细胞移植,分别在76个月和24个月以上无疾病。总之,与其他NHL相比,AILD T-NHL的预后仍然较差。强化治疗和IFNα的作用仍有待评估。

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